Overweight and Hypertension: A 2-Way Street?
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Abstract —Cross-sectionally, higher weight is associated with higher blood pressure levels; prospectively, baseline weight and weight gain predict higher blood pressure. The loss of weight is frequently associated with a decrease in blood pressure. These findings suggest that weight gain may pathophysiologically contribute to blood pressure elevation. In this review, we present data to indicate that the reverse is also true; persons of equal weight who had higher initial blood pressures gain more weight in the future. We also propose a plausible hypothesis to explain this reverse relationship. Both the blood pressure elevation and the gain of weight may reflect a primary increase in sympathetic tone. It is well known that in a milieu of increased sympathetic tone, the β-adrenergic responsiveness decreases. Sympathetic overactivity and decreased cardiovascular β-adrenergic responsiveness have been described in hypertension. β-Adrenergic receptors mediate increases in energy expenditure. If these metabolic receptors were downregulated in hypertension, the ability of hypertensive patients to dissipate calories would decrease and they would gain more weight. The possible relationship of decreased β-adrenergic responsiveness to weight in hypertension can be experimentally tested. Such research may contribute to an explanation of why patients with hypertension can rarely lose weight. An understanding of this pathophysiological relationship may open new avenues for therapeutic interventions.
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Treatment with β-blockers leads to metabolic complications including weight gain.
“Given that excessive sympathetic activity is common in obesity, β-blockers appear as an obvious pharmacologic therapy to treat the hypertension associated with this condition, but treatment with β-blockers leads to metabolic complications including weight gain (16–18).”
From Obesity-Associated Hypertension: Recent Progress in Deciphering the Pathogenesis (2014) · cites this paper as [16]
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Self-citation
- Authors
- Julius, S., Valentini, M., & Palatini, P.
- Affiliations
- University of Padua (IT)
- ORCID
- Palatini, Paolo
- Venue
- Hypertension
- Published
- 2000-03
- Volume
- 35
- Issue
- 3
- Pages
- 807-813
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2130252918
- Cited by
- 253
- References
- 75
- Citations by year
- 2025: 11 · 2024: 7 · 2023: 9 · 2022: 10 · 2021: 6 · 2020: 6 · 2019: 8 · 2018: 6 · 2017: 4 · 2016: 11 · 2015: 16 · 2014: 16 · 2013: 12 · 2012: 10
- FWCI
- 2.32
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Keywords
- overweight, weight gain, blood pressure, weight loss, sympathetic nervous system, beta-adrenergic responsiveness, beta-adrenergic receptor down-regulation, energy expenditure
- MeSH terms
- Adult, Child, Humans, Hypertension, Obesity, Receptors, Adrenergic, Sympathetic Nervous System
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